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Full text of "Rapid Population Growth Consequences And Policy Implications"

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man them, but so little information is available on the kinds and amounts of manpower required for hospitals in LDC's that it seems futile to estimate the health manpower committed to inpatient care. The developmental conditions which are conducive to an urban concentration of doctors apply to modern hospitals as well.
Rural Health Centers. In development plans of most LDC's major emphasis is given to establishing groups of coordinated primary, secondary, and peripheral rural clinics to serve a population of 40,000 to 100,000 people. These clinics are extremely important to the subject of this paper, but they are not included at this time because satisfactory comparable data could not be obtained.
Health Expenditures
The difficulties of obtaining comparable financial data in any field are well known to anyone who has ever attempted to obtain them. Nevertheless, the World Health Organization has moved ahead toward developing governmental health expenditure data which have been utilized in Tables 3 and 4. Despite important unresolved problems affecting the international comparability of these data (23, 24), these kinds of data are being used in national and international planning at present. They are used in this paper to point out the effects of population growth on health services. One hopes their use will also stimulate further improvement of the data themselves.
The range of LDC government health expenditures is much wider than the ranges for manpower and facilities—from 3 U.S. cents per capita per year in Indonesia and 10 in Uganda to 822 in Malaysia and 1,094 in Chile. As a percent of total governmental expenditure, the range narrows considerably— from 0.3 percent in Indonesia to 8.8 percent in Malaysia. Governmental health expenditures in the seven MDC's are much higher—1,363 to 7,777 U.S. cents per capita per year of 4.9 to 13.2 percent of total governmental expenditures.
Among the major problems affecting comparability are:
1.  the exclusion of data for the private sector;
2.  the degree to which data for state and local expenditures are included;
3.  the manner in which development costs, recurring costs, and capital expenditures are included; and
4.  differences in what are called health services (e.g., the degree to which medical care costs and various environmental health services are included).
Because of the special significance of family planning services for population growth and the small number of countries with programs more than a few years old, a special effort was made to identify annual expenditures for family planning in countries with active programs. For purposes of this paper,els of Personal Health Services